Many patients struggle to understand dental insurance. Insurance terms often leave patients unsure what they actually owe. This page walks you through how dental billing and EOBs work at Healthy Teeth Dental.
This guide is ideal for new patients, returning patients checking a bill, or those evaluating dental insurance options. If you need individual assistance, our billing team is happy to help.
How Dental Insurance Works for City Patients
Dental plans are structured to make preventive care more affordable. Most insurance plans use a tiered coverage system:
Preventive services like exams and cleanings are often covered at 100%.
Basic treatments such as fillings and simple extractions are usually covered at 70–80%.
Major dental services tend to be covered at approximately 50%.
A common structure is 100–80–50 for preventive, basic, and major care.
Learn more about our services to better understand your care options.
Common Dental Insurance Terms Explained
Deductible: The amount you pay before insurance starts sharing costs.
Copay / Coinsurance: Your share of costs once insurance applies.
Allowed Amount / Negotiated Fee: The maximum fee your insurance recognizes for a service.
Annual Maximum: The yearly cap on insurance benefits.
Non-Covered Services: Services your plan does not pay for.
Sample Dental Billing Breakdown for Procedure_Type
These numbers are examples and not exact quotes. Final amounts vary by insurance plan.
| Item | Example Amount |
| ------------------------------ | -------------------------- |
| Dentist’s standard fee | Base_Fee |
| Plan’s allowed amount | Allowed_Fee |
| Deductible applied | Deductible_Amount |
| Plan payment (Coverage_%%) | Plan_Payment |
| Patient responsibility | Patient_Responsibility |
Your dental Explanation of Benefits will list similar details.
Dental EOB Explained Simply
After your visit, a claim is submitted to your dental insurance.
You then receive an Explanation of Benefits.
The document outlines insurance and patient responsibilities.
An EOB is not a bill.
Common Dental Billing FAQs
Why is there a difference between the dentist’s charge and the allowed amount?
The allowed amount is set by the insurer.
Does website preventive care really cost nothing?
Many plans cover preventive services at 100%.
What happens when I reach my annual maximum?
You may be responsible for full costs afterward.
Why are some services not covered?
Some procedures are not included under specific policies.
Who should I contact if I disagree with my EOB?
We can assist you in contacting your insurance provider.
Managing Unexpected Dental Costs
Dental costs can be higher due to deductibles, annual limits, or non-covered services. Speaking with our office in advance can help avoid surprises.
Ask for insurance estimates before larger treatments.
Discuss flexible payment solutions.
Timing care may help maximize benefits.
Trusted Dental Care in City
Commitment to clear communication and preventive care.
Easy access for local patients.
Works with a wide range of insurers.
Read what our patients say to learn more.